Nature Versus Nurture I: Of Twins and How David Reimer Became Brenda

They were meant to show that gender was determined by nurture, not nature - one identical twin raised as a boy and the other brought up as a girl after a botched circumcision. But two years ago Brian Reimer killed himself, and last week David - formerly Brenda - took his life too. Oliver Burkeman and Gary Younge unravel the tragic story of Dr Money's sex experiment.

Until a few years ago, the name David Reimer meant little to those outside his immediate circle, and by the time he killed himself last Tuesday in unknown circumstances in his hometown of Winnipeg, it was already slipping back towards obscurity - a name belonging to nobody more remarkable than a local odd-job man, a 38-year-old former slaughterhouse worker who was separated from his wife, and enjoyed shopping at flea markets and tinkering with his car.

In fact, to anyone taking an interest in the development of psychology in the 1970s and 1980s, Reimer's life story would have long been infamous, but also pseudonymous. Going by the name "John", and subsequently "Joan", David Reimer had been an unwitting guinea-pig - along with his identical twin brother Brian - in a medical experiment at first celebrated, then notorious. Masterminded by a prominent Baltimore physician, John Money, it was an attempt to settle, once and for all, the fraught nature-versus-nurture debate: to prove that gender was so fluid that by a mere change in childrearing practice, plus a little surgery, a boy could be turned into a girl, while his twin developed as a male.

It would split the world of sexual psychology in two. And after 12 years of traumatising treatment, followed by a further two decades spent attempting to repair the damage, it would drive David Reimer to his death."It was like brainwashing," Reimer once said, having resumed his male identity after a childhood spent as Brenda. "I'd give just about anything to go to a hypnotist to black out my whole past. Because it's torture. What they did to you in the body is sometimes not near as bad as what they did to you in the mind."

The tragedy has its roots in what seemed like a routine trip to hospital in 1966 for Janet and Ron Reimer and their twin baby boys, Bruce and Brian. Doctors had recommended circumcision, a practice still routine in much of north America, but Bruce's operation went distressingly wrong. Like almost every detail of the story, what actually happened is still fiercely disputed but what is clear is that the electric cauterising machine being used by doctors caused burning to his penis so severe as to render the organ unrescuable.

Reconstructive genital surgery was still rudimentary, and medical experts could offer only pessimism. So when the despairing parents happened to catch a television show, some months later, on which John Money was propounding his radical new theories about gender formation, it seemed to offer a lifeline. "He was saying that it could be that babies are born neutral, and you could change their gender," Janet Reimer later told John Colapinto, author of a book on the experiment entitled As Nature Made Him.

In photographs taken at the time, Money - then, as now, affiliated to Johns Hopkins University in Baltimore, Maryland - looks like a parody of a progressive "sexologist", turtlenecked and moustachioed, and his writings did nothing to dispel that impression. Raised in a conservative religious family in New Zealand, he had rebelled and become a self-described "missionary of sex", revelling in shocked responses to his tireless advocacy of open marriages and - a particular favourite - bisexual group sex.

At their most extreme, Money's public statements had appeared to endorse, or at least not to condemn, incest and paedophilia, but there was no hint of that in the television show Janet and Ron Reimer saw. They wrote to him, and he wrote swiftly back. He was confident, he said, that Bruce could be successfully raised as a girl. From an experimental perspective, Brian Reimer would provide the perfect control: his genetic inheritance was identical to Bruce's. The only difference was that one would be nurtured as a girl, and the other as a boy.

Money's emphasis on nurture over nature played well with the progressive spirit of the times, and especially with the women's movement, its proponents eager to establish that women's traditional social roles were not biologically pre-ordained. "Postwar, in any case, there was a move away from people being innately, biologically, inherently anything," says Lynne Segal, professor of psychology and gender studies at Birkbeck College in London. "We'd just seen Nazism, and the emphasis had been put on the idea that certain people were innately evil - Jews and gypsies, among others - so the emphasis on culture and society fitted well with social democratic ideals." The Reimers did not engage in this kind of debate. "I looked up to [John Money] as a god," Janet said simply.

Bruce Reimer started to become Brenda on July 3, 1967. Physicians at Johns Hopkins surgically castrated him, and the remaining skin was used to forge a "cosmetic vaginal cleft". Money sent the family back to Winnipeg with strict instructions. "He told us not to talk about it," Ron Reimer told John Colapinto. "Not to tell [Brenda] the whole truth, and that she shouldn't know she wasn't a girl."

Things started going wrong almost immediately. Janet Reimer recalled dressing Brenda in her first dress just before the child was due to turn two. "She was ripping at it, trying to tear it off. I remember thinking, 'Oh, my God, she knows she's a boy and she doesn't want girls' clothing." Brenda was bullied viciously at school. When she urinated standing up in the school lavatories, she was threatened with a knifing.

Whether all the blame should lie with Money remains a matter of contention. His supporters argue that reconstructive surgery techniques of the time were such that trying to turn Bruce into Brenda might genuinely have been the least worst option. In public, Money advertised the "John/Joan" study as a resounding success. "This dramatic case," Time magazine reported, picking up on his salesmanship, "provides strong support for a major contention of women's liberationists: that conventional patterns on masculine and feminine behaviour can be altered."

In private, though, things were spinning into chaos. Brenda was required to attend regular therapy sessions with Money in Baltimore, in the company of her brother. According to Colapinto's account, they soon degenerated into horrifying encounters that deeply traumatised the two children. Showing the children "explicit sexual pictures" was seemingly central to Money's theories of gender reassignment. David Reimerlater recalled, as Brenda, "getting yelled at by Money ... he told me to take my clothes off, and I just did not do it. I just stood there. And he screamed 'No!' I thought he was going to give me a whupping. So I took my clothes off and stood there, shaking."

In the children's grimmest recollection - one they found almost impossible to talk about years later - Money allegedly made "Brenda assume a position on all fours on his office sofa and make Brian come up behind her on his knees and place his crotch against her buttocks", an element of Money's theory he referred to as "sexual rehearsal play". (The author John Heidenry, who wrote a recent review defending the sexologist, calls this charge "outrageous and offensive", and says Brian, the source of the claim, may have been suffering false memory syndrome.)

By the time Brenda reached her teens she had attempted suicide at least once; she refused further surgery but consented, though irregularly, to take oestrogen supplements to encourage the development of breasts. John Money gradually drifted from the Reimers' lives, but Brenda remained under constant psychiatric treatment. It was after one such session with a Winnipeg psychiatrist in 1980 that Ron Reimer collected his daughter in the car and, instead of taking her home, drove her to an ice-cream parlour, where he told her everything.

The upturn in Reimer's fortunes lasted several years. Brenda opted for a sex change within weeks of her father telling her the truth. Thanks to developments in phalloplasty, Brenda, taking the name David, received surgery that after five years left him with a reconstructed penis resembling a real one, with limited sensation, and usable for sex. When he was 23 he met Jane, a single mother of three, and married her soon afterwards. In 2000, he went public with his story.

But his happiness didn't last. For reasons that remain unclear, David and Jane eventually separated. Then, two years ago, Brian Reimer apparently killed himself, taking an overdose of drugs he was taking for schizophrenia. David reportedly felt responsible for the death, and visited Brian's grave daily, weeding the plot and bringing fresh flowers.

Despite Colapinto's claims that David made a large amount of money from the book, those who knew him said he was often hard up; at the Transcona golf club, in Winnipeg's eastern suburbs, where he did odd jobs, the members had a whip round for him so he could afford to eat. Friends say he had became particularly distraught during the last few months after he bought thousands of dollars' worth of shares in an investment that flopped.

The world of psychology learned of the failure of Money's experiment through a paper by a rival, Dr Milton Diamond, of the University of Hawaii, who eventually traced those who had taken over treatment of the twins. For Lynne Segal, the story of the experiment does not settle the nature/nurture debate one way or the other - her view, widely shared today, is that the dichotomy is false - but it shows the perils of psychologists trying to prove too much through research. "It's far too simplistic, and far too interventionist, this idea that we can control and model and shape people to prove one thing or another."

John Money remains an emeritus professor at Johns Hopkins. "He's not commenting on this story," his assistant told the Guardian yesterday. "There is no comment to make." Click for Part II.

As Nature Made Him by John Colapinto is published by Quartet, priced £10.

From The Guardian, Wednesday, 12 May 2004.

White Slavery: Lady Florence Baker, 1841-1916

White Slavery and The Dark Continent: Lady Florence Baker, 1841-1916

A European orphaned at four years old, abducted into an Ottoman harem, and raised to become a concubine, Barbara Maria Szasz stood at a white slave auction, ordered to turn so that men could look at the round of her buttocks, the shape of her breasts, the dimple of her cheek, the depth of her eyes. Renamed Florenz, at fourteen she was a fetching prize for the highest bidder, the Pasha of Viddin. She would lead a comfortable life as a toy for his nightly visits until her breasts began to sag and her cheeks wrinkled. After that she would train other maidens to become good concubines, living and dying within the walls of the harem.

That might have happened had Sam Baker, a wealthy English adventurer, not been at the auction. Broken-nosed, bushy-bearded, he had accompanied Duleep Singh. Singh was the maharajah who so desperately wanted Queen Victoria to make him a prince that he gave up the entire Punjab region and the hugely brilliant Kohinoor diamond for the title. Baker, his minder, had been on a Danube hunting trip with him.

Baker caught her eye, and couldn't turn away. He wanted her, and badly. She was very beautiful and she appeared very angry. He was attracted to her but was also moved by compassion and empathy for her plight. Unwilling or unable to outbid the Pasha, he undertook a very dangerous adventure. He stole her from the auction and smuggled her out of Ottoman territory into the Austro-Hungarian Empire. Their chemistry was immediate and they became intimate during the journey, deepening over the years into lasting love.

A widower, Baker left his young family in England with his sister while he traveled the world. This was the age of Victorian prudery, when table legs were covered because they suggested human anatomy. Rather than return home with his young lover, Baker took her, at sixteen, with him into the uncharted regions of the Dark Continent, into areas of Africa far beyond maps. In Medieval times, such places were inscribed on maps by the warning, Here be dragons. With a safari, bearers, scouts, and hunters, they trekked over savannahs, and through forests to discover the source of the Nile. Baker also hoped to rescue John Speke and James Grant, lost somewhere in a region that remained a question mark for the European imagination.

The journey down the Nile took four years. Fluent in Arabic, she often acted as interpreter. He and his young companion witnessed female circumcision, negotiated with hostile tribes, and nearly died of fever. In fact, they found Speke and Grant, and discovered the source of the Nile, which they named Lake Albert, as companion to Lake Victoria, christened by Speke. They also discovered Murchison Falls. In their story, we understand that Baker was not only attracted to his young lover. He had seen her anger but also rescued her because he abhorred slavery. In their travels they entered markets in which slaves were bartered for elephant tusks. Baker swore that the Nile would be free of slavers and slaves.

Back in England, they found their welcome less than gracious, especially for Florence, who was shunned as a loose woman. Queen Victoria refused to receive her in court, although Prince Bertie, Baker's friend, observed regularly to the queen that Florence was quite ladylike.

On the other hand, Sam was awarded a gold medal from the Royal Geographical Society and a knighthood from the Queen. This, along with their marriage, made them more acceptable. As Sir Sam Baker and Lady Florence Baker, they eventually moved in the circles of marquesses, dukes, and the Prince and Princess of Wales. Victoria remained aloof.

They should have had no further needs; respectable society was theirs. They had wealth, privilege, and position, but this was not enough. Baker received a commission from the Viceroy of Egypt. It was to exterminate the black slave trade in Africa, a trade that fed the Ottoman Empire. Despite a small army and navy, Florence and Sam almost lost their lives this time. During his first adventure, Sam Baker had sworn against slavery as his enemy, one that he would wipe out. It was an enemy, though, that almost vanquished them both. This journey was not the same as it was for her at sixteen. Dangerous, the adventure left her frightened and deceived by native tribesmen as they fought with the Bakers and one another. She became disillusioned and never returned to Africa.

Lady Florence arrived in London by a rather incredible series of events. Her father was a Transylvanian officer who wound up on the wrong side of a revolution. Born into a comfortable family in 1841, she was orphaned and forced from her home in Transylvania during the 1848 Hungarian Revolution and then was abducted into a harem from a refugee camp. Nobody could have predicted the destiny that awaited her.

A Somewhat Older Lady Baker

Pat Shipman has written a fine, and well-researched account of Lady Florence's life in To The Heart of The Nile.

Martin Seligman & Happiness

As Fox Leadership Professor of Psychology at University of Pennsylvania, Seligman has undertaken the development of a new approach to psychology. He acknowledges the great contributions of clinical psychology in relieving suffering. The DSM, or Diagnostic & Statistical Manual of Mental Disorders, a psychologist's bible, gives evidence of this. The therapist can consult its pages for various patient symptoms and turn to a classification that professionals on both sides of the Atlantic agree upon. Prozac and a host of other drug psycho therapies have also gone far to relieve patient symptoms. These and various advances have reduced human suffering to foster individuals who can cope with their lives.

Still, Seligman believes more must be done. He acknowledges the progress while noting that ninety percent of psychological science relates to the disease model of therapy. He asks, What about happiness?

To make his point, Seligman notes outcomes of the disease model. One is that psychologists study victims and pathology. This leads to a belief that mental illness is a weight that can almost overwhelm character, responsibility, and related matters. People become victims of their disease with no way out except for the interventions of therapists. Another outcome is that non-victims have had little attention paid to them. That is, they are assumed to have little need for study by psychologists. As a result, efforts were expended to make people less miserable, without attention to making them happier.

As he began to think about this, Seligman asked himself a question, " Who never gets helpless? That is, who resists collapsing? " He became interested in optimism because he discovered that such people didn't think about adverse situations as permanent. Instead the events are regarded as temporary, controllable, local, and not the individual's fault. Those who fell prey to depression or pessimism, see a bad event as permanent, uncontrollable, pervasive, for which they are to blame. He found that these types became ill more frequently while the optimists had better immune systems, and probably lived longer than pessimists.

For his research, he used a term, eudaemonia, the good life.

His eudaemonia has its echo in the Declaration of Independence, that all men are endowed with certain unalienable rights, which include the pursuit of happiness. Seligman observes that Jefferson and the founding fathers didn't have lots of giggles in mind. Nor did they take the modern hedonistic view, that it involves thrills, orgasms, and related highs. Instead, they had a view more akin to Aristotle's, who offers a way to think about happiness when he links it in the Nichomachean Ethics to leisure--not our modern leisure, which is really recreation. No, not water skiing, or NASCAR race watching, but rather leisure as contemplative activity, or as good conversation with people of developed sensibilities.

The key question becomes, How is happiness measured? Psychologists agree upon the symptoms of bi-polar disorder and schizoid paranoia, but what about happiness?

Seligman says that apart from the Hollywood version of happiness in which everybody giggles and has fun, which is merely pleasure, two other types exist. The second type accounts for a person's signature strengths, as Seligman terms them, and life should be reshaped so that these strengths come into play as much as possible. This type involves flow, another term, and one he borrows from Mihaly Csikszentmihaly. If a person truly enjoys something he becomes wholly immersed in it, be it a bridge game or woodworking. This immersion is called flow.

The third type is found beyond the other two, though, and it is a pursuit, the pursuit of meaning, which Seligman relates to the pursuit of happiness as expressed by Thomas Jefferson. In this regard, meaning must connect you to something bigger than the ego, which is too small, too selfish, as a repository for large values.

Meaning can be found in religion, in charity, in work that allows service to others, so long as fairness, justice, and good will are exercised. In short, meaning does not come in a package with a bow ribbon on it. Each of us must find it for ourselves. It can be raising children, saving whales, or fighting in Iraq.

Here, we encounter a problem with meanings as the third happiness type. In Najaf or Bagdad or Falujah, a terrorist fires a rocket-propelled grenade at an American convoy because his beliefs, his meanings, have brought him to Iraq.

Seligman observes that some people don't like his theory because it allows the terrorist in its scope. His answer is that he would condemn the man as evil, but not because of meaning. Education, values, and thought, allow evil to be seen for what it is. Otherwise, it becomes holy righteousness for the ignorant.

He says that he has gathered various interventions to help people become happier, over a hundred in all, and ranging from those endorsed by Tony Robbins to the Buddha. He surmises that ninety percent of them are ineffective, which is to say, placebos. Among these, he includes some interventions offered by Robbins and the Buddha. He doesn't reveal which are ineffective because as placebos they will offer documentation for his happiness research as people take them.

He states that he spent twenty five years studying helpless rats, helpless dogs, and helpless people. Now, he is looking through the binoculars from the other end, and expects that his research will guide people not only to un-learn helplessness but also to learn happiness.

At his web site, Authentic Happiness, he provides a variety of tests for happiness and depression, along with a questionnaire to identify signature strengths such as appreciation of beauty and excellence, curiosity and interest in the world, helping others, and spirituality. As people take these tests he will gather information to help him further develop measures of happiness.

For a related article at this blog, see Learned Helplessness, 2 April 2004, also about Martin Seligman. Helplessness is itself a learned response, and not something that just happens to us. If we learn to respond in this manner we can also learn to take action to improve things.